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Obesity, subclinical myocardial injury, and incident heart failure.

TitleObesity, subclinical myocardial injury, and incident heart failure.
Publication TypeJournal Article
Year of Publication2014
AuthorsNdumele CE, Coresh JJ, Lazo M, Hoogeveen RC, Blumenthal RS, Folsom AR, Selvin E, Ballantyne CM
Secondary AuthorsNambi V
JournalJACC Heart Fail
Date Published2014 Dec
KeywordsBiomarkers, Body Mass Index, Cholesterol, LDL, Coronary Artery Disease, Female, Heart Failure, Humans, Male, Middle Aged, Myocardial Infarction, Natriuretic Peptide, Brain, Obesity, Peptide Fragments, Prospective Studies, Risk Factors, Sex Factors, Troponin T, Waist Circumference

OBJECTIVES: The study sought to evaluate the association of obesity with a novel biomarker of subclinical myocardial injury, cardiac troponin T measured with a new high-sensitivity assay (hs-cTnT), among adults without clinical cardiovascular disease (CVD).

BACKGROUND: Laboratory evidence suggests a relationship between obesity and myocardial injury that may play a role in the development of heart failure (HF), but there is limited clinical data regarding this association.

METHODS: We evaluated 9,507 participants in the ARIC (Atherosclerosis Risk in Communities) study without baseline CVD (Visit 4, 1996 to 1999). We assessed the cross-sectional association of body mass index (BMI) with high (≥14 ng/l) and measurable (≥3 ng/l) hs-cTnT levels after multivariable regression. We further evaluated the independent and combined associations of BMI and hs-cTnT with incident HF.

RESULTS: Higher BMI was independently associated with a positive, linear increase in the likelihood of high hs-cTnT, with severe obesity (BMI >35 kg/m(2)) associated with an odds ratio of 2.20 (95% confidence interval: 1.59 to 3.06) for high hs-cTnT after adjustment. Over 12 years of follow-up, there were 869 incident HF events. Obesity and hs-cTnT were both independently associated with incident HF, and individuals with severe obesity and high hs-cTnT had a greater than 9-fold higher risk of incident HF (hazard ratio: 9.20 [95% confidence interval: 5.67 to 14.93]) than individuals with normal weight and undetectable hs-cTnT.

CONCLUSIONS: Among individuals without CVD, higher BMI has an independent, linear association with subclinical myocardial injury, as assessed by hs-cTnT levels. Obesity and hs-cTnT provide independent and complementary prognostic information regarding the risk of incident HF.

Alternate JournalJACC Heart Fail
PubMed ID25443112
PubMed Central IDPMC4345168
Grant ListHHSN268201100005C / / PHS HHS / United States
HHSN268201100009C / / PHS HHS / United States
5K23HL096893 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100006C / / PHS HHS / United States